Gender, Race, Class and the Normalization of Women's Pelvic Pain

This dissertation, broadly, examines how power dynamics manifest during clinical interactions related to vague and gendered medical symptoms, such as pelvic pain. To examine this issue, I approach my research questions through multiple methods including a critical discourse analysis of the medical discourse on pelvic pain, a survey experiment administered to healthcare workers in the US, and a narrative analysis of pelvic pain patient experiences. While the focus of this research is on pelvic pain, the analyses presented here reach far beyond ideas of power dynamics and pelvic pain. Rather, the findings from this research speak to theoretical discussions medical sociologists have been having for decades. Specifically, findings provide new insight on: 1) the limits of evidence-based medicine as a biomedical paradigm, 2) how fundamental causes of health inequality intersect with each other as well as other factors, such as gender, important in predicting health outcomes and 3) how discussions of metamechanisms in fundamental cause theory can inform our understanding of the accumulation of cultural health capital. In providing such insight, this dissertation uses the case of pelvic pain to integrate multiple perspectives and theories in medical sociology to drive the field forward in a way that acknowledges the many ways power is simultaneously constituted in the clinical interaction. From the role of gender, race, and class in power relations, to the ways medical knowledge, discourse, and authority dictate the clinical interaction, this research covers a wide range of sociological theories and concepts. In doing so, this dissertation sheds new light on current understandings of power in the clinical interaction and its relationship to inequitable health outcomes in the US.